Primary Hyperparathyroidism

Case Description:

This is the baseline DXA scan from a postmenopausal woman referred to Osteoporosis Clinic for low bone density and hypercalcemia. The intact parathyroid hormone level was elevated. A parathyroid adenoma was resected. A year later she had recurrent hypercalcemia and elevation of the intact parathyroid hormone level, and an additional adenoma was found and resected. Completing a wrist scan in a patient with hyperparathyroidism is important as an assessment of cortical bone mineral density.

Credit:

Sarah L Morgan, MD, RD, CCD, The University of Alabama at Birmingham

References:

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• Castellano, E., et al., Forearm DXA Increases the Rate of Patients With Asymptomatic Primary Hyperparathyroidism Meeting Surgical Criteria. J Clin Endocrinol Metab, 2016. 101(7): p. 2728-32.
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• Silverberg, S.J., et al., Current issues in the presentation of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab, 2014. 99(10): p. 3580-94